Journal of anesthesia
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Journal of anesthesia · Jan 2008
Randomized Controlled Trial Comparative StudyBoth clonidine and metoprolol modify anesthetic depth indicators and reduce intraoperative propofol requirement.
Beta-blockers have been used in the past to decrease the depth of anesthesia, but the results are conflicting. However, beta-blockers are known to suppress electroencephalographic activities. This study was carried out to assess the effect of metoprolol on anesthetic depth indicators. We also compared the effect of metoprolol in reducing propofol requirements. ⋯ Our study showed that, like clonidine, metoprolol attenuated the hemodynamic response to intraoperative stimuli and also had a sparing effect on the propofol dose requirement.
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Journal of anesthesia · Jan 2008
Randomized Controlled TrialEffects of landiolol on the cardiovascular response during tracheal extubation.
The objective of this study was to investigate the effect of landiolol on the cardiovascular responses to emergence from anesthesia and tracheal extubation. Fifty-nine patients without cardiovascular disorders who were scheduled for tympanoplasty were randomly allocated to receive a loading dose of landiolol at 0.125 mg x kg(-1) x min(-1) for 1 min, followed by an infusion at 0.01 mg x kg(-1) x min(-1) (group L1), 0.02 mg x kg(-1) x min(-1) (group L2), 0.03 mg x kg(-1) x min(-1) (group L3), or 0.04 mg x kg(-1) x min(-1) (group L4). ⋯ Just after extubation compared with the baseline, the MAP increased significantly in all groups; the HR increased in groups L1 and L2; and the RPP increased in all groups, except for group L4. Continuous administration of landiolol, at 0.03 or 0.04 mg x kg(-1) x min(-1), may prevent the increases in HR and RPP, respectively, that occur at the emergence from anesthesia and tracheal extubation.
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Journal of anesthesia · Jan 2007
Randomized Controlled TrialEffects of magnesium sulfate on neuromuscular function and spontaneous breathing during sevoflurane and spinal anesthesia.
The purpose of the present study was to determine the effects of magnesium sulfate (MgSO(4)) on the neuromuscular function and spontaneous breathing of patients under sevoflurane and spinal anesthesia. Twenty-two patients with a history of arrhythmia undergoing elective knee surgery were randomly assigned to two groups: group M (n = 11), administered with MgSO(4) 40 mg.kg(-1), and group S (n = 11), administered with saline. A combination of spinal anesthesia with 2% sevoflurane inhalation was applied to all patients under spontaneous breathing. ⋯ The VT: , RR, and ET(CO) (2) showed little change in either group, and there was no significant difference between, the groups. The single-twitch response showed significant differences between the two groups (P = 0.0006). The present study indicated that the MgSO(4) had a minimal effect on spontaneous breathing in patients undergoing sevoflurane and spinal anaesthesia, but that it attenuated the safety margin of neuromuscular function.
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Journal of anesthesia · Jan 2007
Randomized Controlled Trial Comparative StudyEfficacy of a heat and moisture exchanger in inhalation anesthesia at two different flow rates.
In general anesthesia with endotracheal intubation, a circle system with a heat and moisture exchanger (HME) and a low total flow is often used to prevent hypothermia and to maintain inspired gas humidity. The purpose of the present study was to compare the inspired gas humidity and body temperature, in general anesthesia with or without an HME at two different total flow rates. Eighty patients (American Society of Anesthesiologists [ASA] I or II) scheduled to undergo either orthopedic or head and neck surgery were studied. ⋯ Group 4L had significantly lower absolute humidity than group 2L. The pharyngeal temperature did not decrease significantly for 2 h in any of the groups. During general anesthesia with a total flow of 2 lxmin(-1) in 2 h, HME might not be necessary, while with a total flow of 4 lxmin(-1), HME could be useful to maintain inspired gas humidity.
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Journal of anesthesia · Jan 2007
Randomized Controlled Trial Comparative StudyHeparin anticoagulation in patients undergoing off-pump and on-pump coronary bypass surgery.
The authors analyzed the coagulation data of patients who underwent on-pump coronary artery bypass graft (CABG) or off-pump coronary artery bypass surgery (OPCAB) in a randomized prospective trial. ⋯ We have shown that the heparin anticoagulation regimen in OPCAB patients does not lead to an immediate hypercoagulable state. Total doses of heparin and protamine were lower in the OPCAB group compared with the CABG group, and there was a residual heparin effect on TEG and PTT in the early postoperative period in the OPCAB group.